微创潜行侧方内括约肌松解术治疗慢性肛裂42例报告

Minimally Invasive Stealth Lateral Internal Sphincter Release for Chronic Anal Fissure: a Report of 42 Cases

目的：探讨微创潜行侧方内括约肌松解术治疗慢性肛裂的安全性和可行性。方法2012年5月～2014年5月，行微创潜行侧方内括约肌松解术治疗慢性肛裂42例，用自制细钢丝从肛缘外1 cm处刺入括约肌间沟，由齿状线上穿出，然后经皮下由肛门外缘穿入口穿出，提起钢丝两头，穿过针筒管，助手固定针筒管，牵拉钢丝游离端，瞬间离断内括约肌组织。结果手术均顺利完成，未见并发症。以患者症状消失、裂口愈合为痊愈标准，痊愈时间7～14 d，平均9 d。随访3～6个月，平均4个月，未见复发。结论微创潜行侧方内括约肌松解术治疗慢性肛裂安全、可行，具有操作简单、疗效可靠、治愈时间短、术后并发症少等优点。

Objective To investigate the safety and feasibility of minimally invasive stealth lateral release operation in the treatment of chronic anal fissure . Methods Clinical data of 42 patients with chronic anal fissure who underwent minimally invasive stealth lateral release from May 2012 to May 2014 was analyzed retrospectively .We use the homemade fine steel wire to pierce into the sphincter ditch with a distance from the anus of 1 cm, and put the steel wire out above the dentate line .Then the wire was took out from the other edge under the skin through the needle of bobbin .After the needle was fixed by an assistant , the free end of the steel wire was pulled quickly to cut the internal sphincter tissue instantly . Results All the 42 patients were successfully treated and discharged without complications .The recovery time was in 7 -14 d, with an average of 9 d.The healing standards included disappeared symptoms and totally healed wound .All the patients were followed up for 3-6 months, with an average of 4 months.No recurrence was found . Conclusion Minimally invasive stealth lateral release in the treatment of chronic anal fissure is safe and feasible, with many advantages such as simple performance , reliable curative effect, fast recovery time, and less postoperative complications .